Leanne Ashmead leads transformation programmes across the imaging and pathology networks of the West of England at a time of immense change for diagnostics teams.
In this Q&A, she outlines the opportunities for digital diagnostics and explains why galvanising everyone around a common goal is vital.
Tell us a bit about your role, what you care about and what you’re working on
I am Programme Director for the West of England Imaging and Pathology Networks.
We’re currently focused on a number of transformation programmes in each network. These include developing the networks (their governance and structures); digital transformation; building a workforce fit for the future; quality, clinical effectiveness and standardisation; capital and equipping; and histopathology, which is a big priority for the Pathology Network as we support our partner Trusts to improve turnaround times.
As networks, we have the opportunity to take a step back and gain a broader view of how things are working, as well as harnessing economies of scale when it comes to delivery. Seeing that bigger picture and having that bigger purchasing power offers lots of opportunities to transform how we deliver diagnostic services in the future.
The two most important areas to me are digital and workforce, as I believe they are the biggest enablers of transformation. For instance, if we can divorce image acquisition from image reporting through digital technologies, we can free up clinicians’ time, work more flexibly and, ultimately, provide better patient care.
As the Programme Director of one of the 22 imaging networks across England, you work across four Integrated Care Systems (ICSs) and seven acute trusts. How do you bring all of those organisations (and their individuals and teams) together to focus on the common goals of the network?
Working as a network is new to everyone. Trusts were set up to compete with each other, then they were asked to collaborate as ICSs and now they are being asked to work together as networks. That is a lot of change – in structure, governance, the leadership skills required and ways of working.
Our partner trust departments have spent many years building diagnostic services they are rightly proud of. Some, therefore, see the networks as a threat – something being imposed on them rather than a change they were part of creating. We are putting a lot of effort into engagement, particularly with the frontline and clinical teams, to help people understand our goals and see their place in the transformation programmes.
We have a strong board with an executive from each organisation in the network; that’s been very helpful in bringing all of the organisations along with us. We’ve also committed to regular meetings with clinicians and divisional managers to ensure everyone at every level is informed about what we’re doing and has the chance to influence the way forward.
The Imaging Network’s digital image sharing programme has garnered support and focus. It’s helped us to move people from a place of fear and concern to real excitement about the changes we can make together.
What we’re trying to do is so transformational and different from traditional ways of working, that it’s not yet in people’s thinking. It will take a long time to get everyone on board with our vision, but one year in, we’re starting to win hearts and minds in helping us shape our transformation journey.
What do you think are the biggest barriers or challenges to implementing effective digital diagnostics systems across networks?
There is a huge amount of pressure on operational service delivery. We must co-design digital diagnostics programmes with users but that can be difficult when they don’t have the capacity to be involved. It’s an ongoing challenge to ensure the right people have the opportunity to influence our work.
IT capacity in the NHS is also an issue. While there is now a much clearer focus on digital, there hasn’t been enough investment in IT capacity and capability so change can be slow.
We’ve got to do transformation right to be effective. Technology without transformation fails. I’ve seen people continue to work in old ways after the introduction of new digital technologies. We need full, comprehensive transformation programmes to have any chance of delivering our goals.
We recently worked with you to review the digital infrastructure needs of the West of England Imaging Network. What advice would you give other healthcare leaders who are at the early stages of establishing digital strategies and architecture?
It’s vital to engage with experts – either within your organisation or external consultants. While we had many skills internally, we didn’t have the technical knowledge or expertise in-house to identify and implement the right digital solutions for our networks. Recognising that at the start and finding the right support was imperative.
Finding ambassadors for your vision across the disciplines of your network(s) is critical. We built strong relationships with several people who have acted as advocates for our vision and transformation programmes in their teams. Their credible, professional voices made it much easier to establish understanding and support from across the organisations, particularly in clinical teams.
Lastly, it’s so important to ensure everyone understands what you’re doing. We found that many people were afraid of technical language and it stopped them engaging in the programme. By communicating in plain English and explaining what the changes we aimed to implement would actually mean for users and patients (through use cases and case studies), we have been able to bring more people on board with our vision.
Looking ahead over the next five years, what three issues/opportunities/challenges will underpin the future of digital diagnostics?
Demand is and will continue to be a huge issue. Demand is rising steadily, particularly for CT and MRI scans, but the workforce is static or decreasing in some cases. We need to embrace digital diagnostics technology to change the way we work and balance our workloads and workforce.
Ageing equipment will be a challenge for many trusts. While new diagnostics equipment is being funded, much of the kit being used is coming to the end of its lifespan and that causes lots of issues. But when budget constraints mean the choice between investing in new equipment or fixing a leaking roof, there is no clear timeline for when the legacy equipment will be replaced.
We have to focus on morale going forward. In the last few years, frontline and clinical teams have managed a massive increase in demand for diagnostics services; responded to a global pandemic; navigated a diagnostics-led pandemic recovery – and, now, we’re asking them to completely change the way they work. People need a break. Diagnostics teams need to know they matter and that their work is seen and valued. We have to show people how important they are.
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